How to have an abortion with pills if mife isn’t available

Abortion pills, often called “medication abortion’, are a safe and effective way to end a pregnancy. In fact, abortion pills now account for more than half of all abortions in the U.S.

There are two “regimens” (aka ways) to have an abortion with pills. One is through a combination of two drugs: Mifepristone and Misoprostol (we usually just say Mife and Miso). The other is using Misoprostol on its own. A comparison of the experience of Mifepristone and Misoprostol compared to Misoprostol alone is also available here.

Given a politically-motivated court case, Misoprostol alone may soon be the only option a clinic can offer, but you may still be able to get both mife and miso online from places like Aid Access or from trusted advocates in your community.

On ineedana.com, you can find all of the verified providers offering all of the options - miso alone, mife and miso, as well as in-clinic procedures.

What is the step-by-step process for having a safe only Miso abortion up to 12 weeks in pregnancy?

Step one: Optional, but highly recommended that you take 800mg of IBUProfen or another painkiller if you’re allergic to ibuprofen. This will help with cramps. Wait an hour for the ibuprofen to kick in.

Step two: Put four 200 microgram (mcg) Miso pills between your cheeks and gum line or under your tongue and hold them there for 30 minutes. Don’t talk or eat while they dissolve. After 30 minutes, drink some water and swallow the rest of the pills (it’s totally ok if they don’t fully dissolve!).

Step three: Wait 3 hours (your 3 hour timer can start when you take the first Miso pills and include the 30 minutes you’re holding the pills in your cheeks or under your tongue).

Step four: After 3 hours, repeat step 2-3! Put another four 200mcg Miso pills in your cheeks or under your tongue and hold them there for 30 minutes. Don’t talk or eat while they dissolve. After 30 minutes, swallow.

Step five: After 3 hours, repeat step 2-3 again! Put four 200mcg Miso pills in your cheeks or under your tongue and hold them there for 30 minutes. Don’t talk or eat while they dissolve. After 30 minutes, swallow.

Make sure you take all 12 pills even if you start to bleed before you’ve taken all of them.

You should expect to have cramping and bleeding, which will be more intense than a heavy period. This is normal. You may also experience nausea, dizziness, vomiting, diarrhea, headache, and fever and chills. All of that is normal and not cause for concern. Be sure to think about self care! Stay hydrated, eat a meal, use a hot compress, have pain meds ready. Do everything that makes you comfortable during a period. It’s often helpful to have a support person with you. For more information, check out this longer, more detailed video.

If you’re having an abortion at home and worried you may be experiencing complications, there is a hotline run by medical professionals. Contact them at 1-833-246-2632. They're available via call or text for 18 hours a day.

How do you know if your abortion was successful?

For most people, the abortion will be complete within 24 hours, but you may still test positive on an at-home pregnancy test for weeks. For accurate results, wait at least 4 weeks to take a pregnancy test.

Additional doses of misoprostol can be used as needed to ensure the abortion is complete. More information on the protocol is available from ACOG and RHAP. One thing to note: abortion accompaniment groups and community providers recommend that people taking misoprostol alone wait until they are at least 5 weeks pregnant (or more) before taking Miso. Their experience is that this will help the medication to be more effective.

You may feel like you want to go to a doctor or clinic to confirm your pregnancy has ended. For some people, this can feel reassuring to know everything went according to plan. This isn’t medically necessary unless you continue to experience pregnancy symptoms. If pregnancy symptoms persist, we recommend using ineedana.com, stillopenclinics.org (our list of former abortion clinics that are still open for other services) or Planned Parenthood’s website to find a follow-up provider who is familiar with abortion care. It’s important to avoid places offering “free ultrasounds” as those are typically anti-abortion crisis pregnancy centers, aka fake clinics.

Note: You do NOT need to tell your healthcare provider, unsupportive family and friends, or police that you took abortion pills. Medically there is no difference between abortion pills and a miscarriage. Link to more info. If you have legal questions about self-managing an abortion, the Repro Legal Helpline can help answer your questions and keep your information confidential.

Looking for more FAQs?

For more information on the abortion pill and ordering online, check out Plan C's website.

If you have additional questions about medication abortion or need assistance while having one, there is a hotline run by medical professionals. Contact them at 1-833-246-2632. They're available via call or text for 18 hours a day.

If you'd like peer support throughout the process of planning or having an abortion with pills at home, check out reprocare's peer-based hotline which is open 7 days a week at 833-226-7821.